[Endoscopic treatment of benign gastrointestinal fistulas]. / Vozmozhnosti éndoskopicheskogo metoda v lechenii svishchei zheludochno-kishechnogo trakta neopukholevogo geneza.

OBJECTIVE: To evaluate the possibility and safety of modified endoscopic stent in the treatment of benign intestinal fistulas. MATERIAL AND METHODS: Analysis of the experience of Sklifosovsky Research Institute for Emergency Care and recent numerous foreign reports confirms that staged treatment followed by delayed radical surgery is the most perspective approach. Modified endoscopic treatment of intestinal fistulas successfully used in 10 patients is reported in the article. RESULTS: Endoscopic stenting of various parts of gastrointestinal tract is a minimally invasive treatment of this pathology and not followed by complications and mortality. An important advantage is early closure of fistula that reduces duration of treatment and improves further social and labor rehabilitation of patients.

[Influence of the antihypoxantic therapy on children with generalized peritonitis]. / Vliyanie antigipoksantov na rezul'taty lecheniya rasprostranennogo peritonita u detei.

AIM: To improve the results of treatment of a widespread purulent peritonitis in children by optimizing fluid therapy includes the use of combined treatment: reamberin and remaxol. MATERIAL AND METHODS: We studied 269 patients aged 1 to 15 years with a widespread purulent peritonitis treated at the children's surgical departments in Samara from 2001 to 2015. The study group included 179 children who used the optimized infusion therapy. In the study group was allocated to 2 groups: 69 children in infusion therapy which used reamberin and 110 patients in which treatment was applied reamberin and remaxol. The surgical treatment used laparoscopic sanation of the abdomen. Comprehensive survey included a study of dynamics of the white blood cell count, leukocyte index Kalf-Caliph, erythrocyte sedimentation rate, temperature, total albumin concentration, transaminase levels. Catamnesis studied 48 patients with the definition of complex intima-media thickness in the projection of basilar, brachial and femoral arteries. RESULTS: A study compared indicators of both groups, revealed a more rapid reduction of intoxication symptomps (leukocytosis, LII, body temperature), the disappearance of enteric disease, recovery of protein-synthetic function of the liver, decrease of cytolytic and mesenchymal-inflammatory syndromes in the main group, especially in the subgroup in which treatment was included remaxol. CONCLUSION: The use of reamberin and remaxol in infusion therapy led to improvement of the results of the treatment of common purulent peritonitis in children. Study catamnesis with the study of the intima-media revealed that children undergoing widespread purulent peritonitis further develop signs of endothelial dysfunction. The developed clinical recommendations to significantly reduce the risk of developing signs of endothelial dysfunction, thereby reducing the possible appearance of vascular pathology in patients who underwent childhood widespread purulent peritonitis.

[Treatment of diffuse peritonitis in children].

THE PURPOSE OF THE STUDY: Improving the treatment of advanced peritonitis via use in therapy antihypoxant Reamberin and hepatoprotector Remaxol, nutritional support, sanitation laparoscopic abdominal cavity. SUBJECTS: A total of 232 children aged 1 to 15 years with generalized purulent peritonitis treated at the children's surgical departments of Samara from 2001 to 2014. A study group comprised 148 patients who used the optimized pathogenetic therapy. In the study group was allocated two groups: 64 patients in the pathogenetic therapy that used antihypoxant reamberin, and 84 children in the treatment of which reamberin and hepatoprotector remaxol. All the children of the main group received nutritional support (trophic feedings), used in the surgical treatment of abdominal laparoscopic sanitation. Comprehensive survey includes the study of the dynamics of the level of white blood cells, leukocyte index on Kalf-Caliph, erythrocyte sedimentation rate, temperature, total albumin concentration, transaminase levels. RESULTS: Comparison of the studied parameters in the study and control groups, showed a more rapid decrease in the symptoms and signs of intoxication (leukocytosis, LII, body temperature), relief of enteric disease, recovery of protein-synthetic function of the liver, a decrease of cytolytic and mesenchymal-inflammatory syndrome in the study group, especially in the subgroup in which therapy was included remaxol. CONCLUSIONS: Optimization of treatment involving the application of the combined drugs--antihypoxant reamberin, hepatoprotector remaxol, nutritional support and implementation of laparoscopic abdominal sanitation led to improved results of therapy common purulent peritonitis in children.

The fixed combination efficacy assessment in patients with secondary neovascular glaucoma and diabetes mellitus.

PURPOSE: To assess IOP-lowering efficacy of bimatoprost/timolol fixed combination (Ganfort®) in patients with diabetes mellitus (DM) and uncontrolled secondary neovascular glaucoma (NG). MATERIALS AND METHODS: Fifty patients (51 eyes) with uncontrolled secondary neovascular glaucoma and diabetes mellitus were enrolled in the study. All patients with an uncontrolled IOP have been proposed to switch current IOP-lowering therapy to Ganfort®. In case target IOP level was not reached filtration surgery was recommended. Ganfort® administration - once a day in the morning. RESULTS: IOP-lowering has been observed in all patients when switched to Ganfort®. Mean IOP level was almost 3-x lower versus baseline in 72.5% of patients (37 eyes). The patients achieved target IOP of 15-17 mmHg. As a result, no surgical intervention was required. Significant IOP-lowering has been observed in another group of patients (14 eyes, 27.5 %) nevertheless due to glaucoma progression, these patients are still subjected to surgical treatment. CONCLUSION: IOP-lowering fixed combination Ganfort® (Allergan) can be used in patients with secondary neovascular glaucoma and diabetes mellitus as a drug of choice to control the IOP level. Even in cases when target IOP is not achieved, Ganfort® can be administered in pre-operative period and helps to reduce postoperative complications.

Transformations of the macromolecular landscape at mitochondria during DNA-damage-induced apoptotic cell death.

Apoptosis is a dynamic process regulated by mitochondrion critical for cellular respiration and survival. Execution of apoptosis is mediated by multiple protein signaling events at mitochondria. Initiation and progression of apoptosis require numerous apoptogenic factors that are either released from or sequestered in mitochondria, which may transform the biomolecular makeup of the organelle. In this communication, using Raman microspectroscopy, we demonstrate that transformation in biomolecular composition of mitochondrion may be used as apoptosis marker in an individual cell. For the first time, we show that significant changes occur in the concentrations of RNA, DNA, protein, and lipid constituents of mitochondria during apoptosis. The structural analysis of proteins on mitochondria demonstrated a decrease in α-helix secondary structure content, and an increase in the levels of random coils and ß-sheets on mitochondria. This may represent an additional hallmark of apoptosis. Strikingly, we observed nearly identical changes in macromolecular content of mitochondria both in the presence and absence of a key proapoptotic protein, Bax (Bcl-2-associated X protein). Increased DNA level in mitochondria corresponded with higher mitochondrial DNA (mtDNA), cellular reactive oxygen species (ROS), and mitochondrial ROS production. Upregulation of polymerase-γ (POLG), mitochondrial helicase Twinkle, and mitochondrial transcription factor A (Tfam) in response to DNA damage correlated with increased mtDNA and RNA synthesis. Elevated activity of oxidative phosphorylation complexes supports functional mitochondrial respiration during apoptosis. Thus, we define previously unknown dynamic correlation of macromolecular structure of mitochondria and apoptosis progression in the presence and absence of Bax protein. These findings open up a new approach for monitoring physiological status of cells by non invasive single-cell method.

Diagnostic and remedial capability of transcervical falloposcopy in conjunction with laparoscopy.

STUDY OBJECTIVE: Tubal factor accounts for 25-30% of cases of female infertility. Laparoscopy "Gold Standard" for tubal evaluation. However, it is known that during the initial infection of the fallopian tube mucosal damage occurs, a condition which plays a decisive role in reproduction. MATERIALS AND METHODS: In this prospective randomized study, 468 infertile women with evidence of fallopian tube disease were included. In this, for 256 patients (group 1) after laparoscopic salpingolysis, salpingostomy we performed an additional step operation transcervical falloposcopy tubal dilatation (TFTD). 212 patients (group 2) produced only laparoscopic salpingolysis, salpingostomy. RESULTS: As a result, TFTD patency of the fallopian tubes for coaxial catheter was restored in 50 (78%) of 64 tubes with bilateral total occlusion, in 238 (93%) of 254 with partial occlusion of the bilateral, in 14 (58%) of 24 total unilateral occlusion and 26 (92%) of 28 with partial unilateral occlusion. Total number of pregnancies for one year in the first group of patients was 152 (59.3%), in the second 57 (27.1%), of which in the first group 147 -intrauterine pregnancies (57.4%) and in the second - 46 (21.7%). CONCLUSION: Falloposcopy surgeon provides good opportunities for the diagnosis and treatment of intralumen lesions. Significant increase in the frequency of uterine pregnancy in the case of an additional step - TFTD during salpingolysis, salpingostomy in patients with tubal factor infertility.

Role of nicotinic and muscarinic cholinoreceptors in the realization of the cholinergic anti-inflammatory pathway during the early phase of sepsis.

Stimulation of nicotinic and muscarinic cholinoreceptors (nAChR, mAChR) in outbred albino mice with nicotine and aceclidine, respectively, in single equilethal doses 0.5 DL(50)6 h before sepsis induction significantly reduced animal mortality due to a decrease in blood concentrations of proinflammatory cytokines IL-1ß, IL-6, and MIP-2. Stimulation of mAChR (injection of aceclidine) stimulated the neutrophilic phagocytic and metabolic activity. Realization of the cholinergic anti-inflammatory pathway (stimulation of the peripheral nicotinic cholinoreceptors (α7nAChR) and central muscarinic cholinoreceptors (mAChR) was modulated by stimulation of the muscarinic cholinoreceptors of the phagocytic monocytic system cells.

Effects of reversible inhibition of cholinesterase and nicotine on mouse mortality and blood levels of proinflammatory cytokines during the early phase of sepsis.

Experiments on outbred albino mice have shown that proserine (reversible cholinesterase inhibitor) and nicotine (nicotinic receptor agonist) in a equivalent dose of 0.2 DL(50)injected 2 h before sepsis induction significantly reduced animal mortality from experimental infection due to reduction of blood concentrations of proinflammatory cytokines TNF-α, IL-1ß, and IL-6.

An immunomodulatory procedure that stabilizes transgene expression and permits readministration of E1-deleted adenovirus vectors.

Immune responses against E1-deleted adenovirus vectors and/or their transgene products result in the rapid elimination of vector-transduced cells and the generation of neutralizing antibodies. Different strategies of immunomodulation to stabilize transgene expression at therapeutic levels and to permit productive vector readministration have been examined. Our previous studies have shown that depletion of macrophages from spleen and liver decreases hepatic inflammation, significantly prolongs transgene expression, and delays the onset of humoral immune responses after systemic administration of an E1-deleted adenovirus vector. In the present study, we have examined the effects of macrophage depletion in combination with temporary blockade of CD40 ligation on E1-deleted adenovirus vector-mediated gene transfer. Alone, each of these treatments significantly inhibited the humoral immune response against the transgene product and prolonged its expression. Together, these treatments completely stabilized transgene expression and inhibited the production of neutralizing anti-adenovirus antibodies, permitting successful vector readministration. Animals rendered immunologically unresponsive to vector and transgene antigens regained their ability to mount productive immune responses against the vector after recovery of immune function, but remained unresponsive to the transgene product. These experiments demonstrate that this treatment is transient and antigen-specific.

Evaluation of hexose monophosphate shunt activity in isolated murine lens by monitoring the potential of the ferricyanide--ferrocyanide system.

A method for evaluation of the activity of the hexose monophosphate shunt (HMS) in isolated lens is presented. The measurement of HMS activity is based on continuous monitoring of the potential of the ferricyanide--ferrocyanide system (where ferricyanide is an artificial electron acceptor) in the presence of a lens. The rate of reduction of ferricyanide increased after the addition of methylene blue (MB) or saponin. The ferricyanide reduction rate did not correlate with GSH content in the contralateral lenses of the same mouse in the absence of MB or saponin. Correlations between the ferricyanide reduction rate and GSH content in the lens were 0.67 (beta = 0.93) in the presence of MB and 0.82 (beta = 0.95) in the presence of saponin. We think that the measured curves of ferricyanide reduction are representative of: 1) normal level of HMS activity (in the absence of methylene blue and saponin); 2) maximal HMS activity (in the presence of methylene blue); 3) the intracellular concentration of reducing equivalents (in the presence of saponin).

Differences in the effect of chronic and acute caffeine on self-administration of cocaine in mice.

We have compared the ability of an acute injection of caffeine (3 mg/kg, i.p.) and long-term peroral caffeine consumption for 10 days ( approximately 150 mg/kg/day in tap water) to affect cocaine self-administration in mice. The peak plasma and brain levels of caffeine and its metabolites were similar in the two experimental set-ups. Moreover, the levels reached are close to those obtained in humans upon coffee ingestion. Neither type of caffeine administration affected the reinforcing effect of cocaine, defined as a selective increase in nose-poke responses in mice self-administering cocaine compared to their yoked controls. However, caffeine injection increased the amount of cocaine self-administered whereas caffeine drinking reduced it. A low dose of cocaine, by itself essentially ineffective, produced an increase in c-fos and NGFI-A mRNA in the cerebral cortex in mice that had been drinking caffeine. An acute caffeine injection also enhanced the immediate early gene response to cocaine, but to a lesser degree. Cocaine and caffeine also synergistically increased NGFI-A expression in caudate-putamen. Thus, regular caffeine drinking decreased the cocaine intake without significantly affecting its reinforcing properties, perhaps because it enhanced the activation of the predominantly inhibitory frontal cortical areas produced by low doses of cocaine.

Effects of preconditioning on myocardial interstitial levels of ATP and its catabolites during regional ischemia and reperfusion in the rat.

The interstitial accumulation of adenine nucleotide breakdown products (ANBP) in the myocardium during ischemia has been shown to provide a useful index of the ischemic injury, whereas reperfusion ANBP washout rate has been regarded as an index of reperfusion damage. The purpose of this study was, using cardiac microdialysis, to examine in the rat model of regional ischemia/reperfusion the relationship between the duration of ischemia and these indices and to assess the profile of interstitial ATP concentrations and the beneficial effects of ischemic preconditioning (IP). The rats underwent 10, 20, 30 or 40 min of coronary artery occlusion and 50 min of reperfusion. Regional ischemia, with its duration, provoked a progressive increase in dialysate ANBP in the ischemic zone. The rate of purine washout during reperfusion exponentially declined with an increase in duration of the ischemic period. IP, induced by three 5-min episodes of ischemia, each separated by 5 min of reperfusion, significantly reduced the accumulation of ANBP during the 30-min period of sustained ischemia and resulted in a marked acceleration of reperfusion ANBP washout, indicating the improvement of postischemic microcirculation. These effects were suggested to be, at least in part, responsible for the infarct size limitation observed. Using the relationship between the duration of ischemia and ANBP washout rate, it could be demonstrated that IP produced similar facilitation of purine washout as shortening of the ischemic period in nonpreconditioned rats from 30 to approximately 7 min. Regional 20-min ischemia induced an early peak increase in interstitial fluid ATP which correlated with the maximal incidence of ventricular arrhythmias, whereas IP abolished both ATP release and arrhythmias during the sustained ischemia. These findings suggest that ATP may be an important mediator of ischemia-induced ventricular arrhythmias.

Expression of c-fos, NGFI-A and secretogranin II mRNA in brain regions during initiation of cocaine self-administration in mice.

Intravenous cocaine self-administration in mice was studied to find correlates of the acquisition of cocaine-oriented operant behaviour in the expression of nerve growth factor-induced clone A (NGFI-A), c-fos and secretogranin II mRNAs. Yoked control animals, receiving cocaine passively, served as controls for the neurochemical effect of non-contingent cocaine infusion. Animals controlling their cocaine infusions did more nose-pokes during a 30-min trial than yoked controls and animals receiving only saline, indicating a reinforcing effect of cocaine. Compared with saline, an increase in c-fos mRNA in lateral and basolateral amygdala was found in active cocaine-receiving animals, and a decrease in yoked controls receiving cocaine. There is previous evidence for an involvement of the amygdala, particularly its basolateral part, in cocaine's effects on motivation. In caudate putamen, both contingent and non-contingent cocaine increased c-fos mRNA. Non-contingent cocaine infusions increased NGFI-A mRNA expression in the core of nucleus accumbens, medial caudate putamen and frontal cortex, whereas self-administration eliminated these effects. In the core of the nucleus accumbens and piriform cortex there was increased, and in medial amygdala decreased secretogranin II mRNA in yoked controls compared with saline controls. In contrast, in basomedial and central nuclei of amygdala, increased secretogranin II mRNA was found in self-administering mice. Previous studies measuring gene expression after cocaine administration obviously did not give the complete picture of changes in gene expression in the drug-taking organism. As differences in c-fos and secretogranin II mRNA between active mice and yoked controls were robust, measuring these mRNAs may identify neurons selectively involved in acquisition of cocaine-taking behaviour.

Caffeine, acting on adenosine A(1) receptors, prevents the extinction of cocaine-seeking behavior in mice.

Drug-naive DBA/2 mice were trained to self-administer cocaine (40 microgram/kg/infusion) i.v. by nose poking. The number of nose-poke responses was higher in mice receiving response-contingent injections of cocaine (active group) than in yoked controls or in animals receiving response-contingent saline injections. Twenty-four hours after the training session (cocaine or saline self-administration), mice were injected i.p. with saline, cocaine, caffeine, 1,3-dipropyl-8-cyclopentyl xanthine (DPCPX), 8-cyclopentyl theophylline (8-CPT), 5-amino-7-(2-phenylethyl)2-(2-furyl)-pyrazolo-[4,3-e]-1,2, 4-triazolo[1,5-c]pyrimidine (SCH 58261), or 9-chloro-2(2-furyl)[1,2, 4]triazolo[1,5-c]quinazolin-5-amine (CGS 15943) and placed again in exactly the same operant boxes as during the training session but without response-contingent i.v. infusions. Saline injection elicited similar responding in animals from the active group and from the yoked control group. A low dose of cocaine (5 mg/kg) or caffeine (3 mg/kg), but not higher doses, produced greater responding in the active group than in the yoked control group during a single extinction trial. The adenosine A(1)-receptor antagonists DPCPX and 8-CPT and the nonselective antagonist CGS 15943 partially reproduced the effect of a low dose of caffeine on the cocaine-associated behavior in a dose-dependent manner and did not alter the nose-poke activity of yoked control mice in the extinction experiment. In contrast, the adenosine A(2A) antagonist SCH 58261, in doses above 1 mg/kg, reduced nose-poke activity equally in active and yoked control animals. This confirms that a drug from a different pharmacological class (adenosine-receptor antagonist) can induce behavior changes similar to the effects of the original self-administered drug (indirect dopamine-receptor agonist). The data also suggest that the effects of caffeine on cocaine-seeking behavior might be related to interaction with adenosine A(1) receptors, but not A(2A) receptors.

Interstitial ATP level and degradation in control and postmyocardial infarcted rats.

With the aim of estimating interstitial levels and the breakdown process of ATP, cardiac microdialysis was performed in the left ventricular wall of in situ control and postinfarcted as well as of isolated, Langendorff-perfused rat hearts. With the use of a bioluminescence technique for dialysate ATP measurement, the baseline interstitial fluid ATP concentration in in situ hearts was estimated to be 38 +/- 8 nM. Regional ischemia induced an early peak increase in interstitial fluid ATP to 373 +/- 73 nM that correlates with the maximal incidence of ventricular arrhythmias. During continuous infusion of individual adenine nucleotides (50 microM ATP, ADP, or AMP), the dialysate samples were analyzed for adenine nucleotides, nucleosides, and bases using HPLC with ultraviolet detection. The patterns of catabolites were consistent with the major pathway of metabolism, that is, sequential dephosphorylation catalyzed by a chain of separate ecto-nucleotidases. In in situ postinfarcted hearts as well as in perfused hearts, a reduced catabolism rate of extracellular adenine nucleotides was observed. In conclusion, in in situ rat hearts, ATP can be released in substantial amounts in the interstitium where it readily undergoes enzymatic degradation. Dephosphorylation occurs sequentially and faster in in situ control hearts than in in situ postinfarcted or in perfused hearts.

Association of pre-ischaemic disturbances in energy metabolism with postischaemic dysfunction of the rat isolated working heart.

1. Metabolic and functional effects of two protocols of preconditioning were compared in rat isolated hearts subjected to 20 min global ischaemia (37 degrees C) and reperfusion (30 min Langendorff + 15 min working). Prior to the ischaemic period, hearts were perfused according to Langendorff (control group) or were preconditioned by three 5 min cycles or two 10 min cycles of ischaemia and reperfusion (PC-I and PC-II groups, respectively). 2. There was no difference in the contractile function between the two preconditioned groups at the onset of sustained ischaemia, although the PC-II group showed enhanced release of adenosine (Ado), inosine, hypoxanthine and xanthine into the interstitium accompanied by losses of tissue adenine nucleotides (sigmaAN = ATP + ADP + AMP), total creatine (sigmaCr = phosphocreatine + creatine) and activation of glycolysis following the preconditioning period. During reperfusion, the PC-I group showed enhanced functional recovery, higher contents of sigmaAN and sigmaCr, and the smallest lactate dehydrogenase release compared with these indices in the control and PC-II groups. Postischaemic myocardial dysfunction was similar in the control and PC-II groups. 3. Functional recovery of hearts in both preconditioned groups was positively correlated with myocardial contents of ATP, sigmaAN and sigmaCr at the end of reperfusion, but not with pre-ischaemic Ado release into the interstitium. The results suggest that pre-ischaemic disturbances of energy metabolism, rather than activation of Ado receptors or stunning, may contribute to efficacy of multiple preconditioning in the rat isolated heart.

Macrophage depletion increases the safety, efficacy and persistence of adenovirus-mediated gene transfer in vivo.

The consequences of macrophage depletion achieved by intravenous infusion of liposome-encapsulated clodronate (dichlormethylene diphosphonate (Cl2MDP)) on adenovirus-mediated transfer of a recombinant human alpha 1-antitrypsin (hAAT) gene were examined in 12-14-week-old male Balb/c mice. The levels of hAAT expression following tail vein infusions of 10(9) p.f.u. of Ad.RSV-hAAT were approximately four-fold higher in macrophage-depleted animals than in control animals pretreated with liposome-encapsulated phosphate-buffered saline (PBS). Clodronate pretreatment also significantly increased the survival of animals injected with high doses of viral vector. Long-term studies performed in animals receiving tail vein infusions of the adenoviral vector also indicated that clodronate pretreatment significantly attenuated the rapid loss of transgene expression usually observed in immunocompetent animals. These findings indicate that the depletion of macrophages before adenovirus-mediated gene transfer may increase the transduction efficiency and reduce the rate of immunologic elimination of the adenovirally transduced cells, thereby increasing the persistence of transgene expression in immunocompetent animals.

Isradipine inhibits nicotine intravenous self-administration in drug-naive mice.

The effect of isradipine, a dihydropyridine calcium antagonist, on intravenous self-administration of nicotine in naive mice has been investigated. When nicotine injections were made contingent upon nose-poke response by naive mice, they increased their rate of nose poking with respect to animals receiving contingent saline injections or yoked control animals receiving noncontingent nicotine injections. Pretreatment of mice with mecamylamine (2.4 mg/kg) inhibited self-administration of nicotine contingent upon a nose-poke response. The same effect was observed with isradipine (0.5-1.0 mg/kg) in a dose-related manner and stereospecifically. These data suggest that isradipine suppresses the reinforcing properties of nicotine and might be useful for treatment of nicotine abuse.

Allopurinol: kinetics, inhibition of xanthine oxidase activity, and protective effect in ischemic-reperfused canine heart as studied by cardiac microdialysis.

With microdialysis, we monitored cardiac interstitial fluid (ISF) levels of allopurinol, its metabolites, and the adenine nucleotide breakdown products (ANBP), inosine, hypoxanthine (HYP), xanthine (Xa), uric acid (UA) in dogs that received 1 and 10 mg/kg allopurinol intravenously (i.v.). Half-life (t1/2) of drug penetration into the heart was dose independent (1.8 min), whereas for the 10-mg/kg dose terminal elimination t1/2 (96 min) was much prolonged and ISF clearance (9.6 l/min kg) was reduced as compared with that induced by 1 mg/kg (28 min and 30.4 l/min kg) probably due to capacity limitation of allopurinol conversion to oxypurinol by Xa dehydrogenase/oxydase (Xa D/O). Inhibition of Xa D/O activity by allopurinol resulted in a dose-dependent increase in ISF HYP and Xa levels and a decrease in UA level. For a 10-mg/kg dose, maximal effect was attained approximately 40 min after drug injection. Allopurinol (1 mg/kg) given 30 min after the start of 40-min coronary artery occlusion during ischemia entered the ischemic zone ISF very slowly as compared with that of the control zone; the no-reflow phenomenon was evident because the levels became similar in both zones only 15 min after initiation of reperfusion. To examine cardioprotective efficiency, we administered allopurinol (10 mg/kg) 40 min before 40-min occlusion; it had little effect on total ANBP release during ischemia but facilitated washout of ANBP from the ischemic zone during reperfusion, thus manifesting protective efficacy against reperfusion injury and no-reflow. As shown by the lack of ischemia-induced increase in ISF Xa, myocardial Xa D/O activity was completely blocked by allopurinol.